Provider Demographics
NPI:1235590316
Name:ISAAC, LUCIEN NAHUM (LPC)
Entity Type:Individual
Prefix:
First Name:LUCIEN NAHUM
Middle Name:
Last Name:ISAAC
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3680 N INVESTMENT DR STE 1
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-5458
Mailing Address - Country:US
Mailing Address - Phone:479-966-9717
Mailing Address - Fax:479-332-4932
Practice Address - Street 1:3680 N INVESTMENT DR STE 1
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-5458
Practice Address - Country:US
Practice Address - Phone:479-966-9717
Practice Address - Fax:479-332-4932
Is Sole Proprietor?:No
Enumeration Date:2016-03-16
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP2109008101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health